Provider Demographics
NPI:1417289836
Name:REL DISTRIBUTING INC.
Entity type:Organization
Organization Name:REL DISTRIBUTING INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:RONALD
Authorized Official - Middle Name:E
Authorized Official - Last Name:LANNHOLM
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:623-930-0152
Mailing Address - Street 1:6802 W FRIER DR
Mailing Address - Street 2:SUITE 3
Mailing Address - City:GLENDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85303-1333
Mailing Address - Country:US
Mailing Address - Phone:623-930-0152
Mailing Address - Fax:623-939-0018
Practice Address - Street 1:6802 W FRIER DR
Practice Address - Street 2:SUITE 3
Practice Address - City:GLENDALE
Practice Address - State:AZ
Practice Address - Zip Code:85303-1333
Practice Address - Country:US
Practice Address - Phone:623-930-0152
Practice Address - Fax:623-939-0018
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-02-10
Last Update Date:2010-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes335E00000XSuppliersProsthetic/Orthotic Supplier